Age at interview: 51
Diagnosis: Medically-induced early menopause (following treatment for endometriosis)
Age at diagnosis: 44
Background: Natalie works full-time in occupational health and safety. She lives in a metropolitan city with her husband. She is from an Australian background.
About Natalie: In her early 40s, Natalie and her husband experienced difficulties getting pregnant. Following investigations, Natalie learned she had a uterine fibroid and endometriosis. After surgical removal of the fibroid, her periods became irregular and at 44 she had a hysterectomy because of her endometriosis. Natalie began experiencing hot flushes, night sweats, and weight gain and was diagnosed with early menopause. Unable to tolerate Hormone Replacement Therapy (HRT), she exercises and tries to eat well instead.
More about Natalie: Natalie met her husband at 40, and soon after they began trying to become pregnant. However, Natalie needed an abdominal myomectomy to remove a uterine fibroid, which ‘caused a bit of a delay.’ After the surgery, her gynaecologist advised her that she also had endometriosis, and recommended she try to bring ‘forward’ getting pregnant.
After the myomectomy, Natalie’s menstrual periods became irregular, which was difficult because it meant she would get ‘excited’ when her period didn’t come, thinking she was pregnant. A year later, Natalie had another laparoscopy which again revealed endometriosis. After a third laparoscopy, another year on, her gynaecologist advised her that because the endometriosis had caused ‘damage,’ she would need a hysterectomy. Hearing this was ‘really hard’ for Natalie as it meant she and her husband would ‘never have children.’ Nonetheless, she decided to go ahead with the surgery.
Although Natalie’s gynaecologist left her ovaries in to prevent menopause, soon after her hysterectomy she began experiencing hot flushes and weight gain, despite no changes to her diet or lifestyle. Following blood tests, her gynaecologist diagnosed her with early menopause.
Natalie was prescribed HRT, but experienced migraines with tablets and skin burns from patches. She also tried a non-hormone based medication (gabapentin) but this ‘brought on’ diarrhoea. Eventually Natalie decided to stop taking any medication.
Weight gain has been the ‘most hated’ symptom of early menopause for Natalie, as she has always eaten ‘healthily’ and exercised regularly. She finds hot flushes at work ‘frustrating,’ and often feels tired because of night sweats and interrupted sleep. Natalie also feels early menopause has worsened her arthritis.
Natalie described the ‘emotional side’ of having a hysterectomy and early menopause as very difficult. Most of her family members and friends have children, and she recalled ‘feeling a bit of a failure’ because she wasn’t able to ‘be a mum.’ A year before her hysterectomy, Natalie and her husband had investigated IVF and adoption, but after learning that because of Natalie’s age, their chance of success with IVF or of being chosen as an adoptive parent would be low, they decided not to pursue these options.
Natalie’s husband and family have been ‘understanding’ and supportive, and she has a particular ‘connection’ with another friend who has not had children. Becoming a dog owner and looking for ‘silver linings,’ such as more time to care for her elderly parents, have helped Natalie adjust to early menopause. She advised other women in similar circumstances not to feel ‘embarrassed’ about their symptoms and to look for a doctor who will take them ‘seriously.’
 Use of HRT until the natural age of menopause (51 years) is recommended for women with spontaneous POI for menopausal symptoms as well as bone and heart health, unless there is a medical reason not to take oestrogen, e.g. if women have personal experience of breast cancer, or experience side-effects they cannot tolerate.